Human Immunodeficiency Virus in Kidney Transplantation

Semin Nephrol. 2016 Sep;36(5):405-416. doi: 10.1016/j.semnephrol.2016.05.017.

Abstract

Patients infected with human immunodeficiency virus (HIV) are living longer, healthier lives on highly active antiretroviral therapy and, as a result, interest in kidney transplantation for HIV-infected patients with end-stage renal disease has increased. HIV is no longer considered a contraindication to solid-organ transplantation and the number of kidney transplants performed in HIV-infected patients each year is increasing steadily. HIV-infected kidney transplant recipients have had excellent outcomes overall, but there are still significant challenges, including high rates of acute rejection, drug-drug interactions, and poor outcomes in patients co-infected with hepatitis C virus. The gap between supply and demand for organs remains a challenge but new developments in HIV-positive to HIV-positive kidney transplantation may help bridge this gap.

Keywords: HIV-infected deceased donors (HIVDD); Human immunodeficiency virus (HIV); drug interactions; highly active antiretroviral therapy (HAART); kidney transplant.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Coinfection
  • Drug Interactions
  • Graft Rejection / prevention & control*
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Hepatitis C, Chronic / complications
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Immunosuppressive Agents